Failure to Timely Refund Deceased Resident’s Funds to Representative
Penalty
Summary
The facility failed to refund all monies due to a deceased resident’s representative within 30 days of the resident’s death, as required by regulation and the facility’s own refund policy. The resident had resided in the facility for approximately nine years and was Medicaid-eligible, with a gross monthly income of $1,159.22 and a personal needs allowance of $160.00 per month. Billing records showed that the resident’s husband paid a monthly patient responsibility of $314.92 from their joint checking account. Despite the resident’s death, this patient responsibility continued to be drawn from the joint account in the month following death, 13 days after the resident had passed away. Email correspondence showed that the Business Office Manager notified the corporate office accounting department of the resident’s death and requested removal of the resident from Automated Clearing House (ACH) payments. Additional emails documented that the facility was aware the husband was requesting a refund and that the family was due a larger refund than initially believed. At the time of the survey, over four months after the resident’s death, the Corporate Regional Director of Operations and the Administrator confirmed that the resident’s husband was still owed a refund totaling $1,905.35 and that no refund had been issued. The Administrator stated that the Business Office Manager did not have authority to issue refund checks and that they had been waiting for the corporate office to process the refund, contrary to the facility’s written policy requiring final accounting and conveyance of funds within 30 days of death.
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